1. Field of the Invention
The invention relates to retractors that are used in various types of surgeries such as cardiovascular surgery and, more particularly, to a retractor that can be conveniently assembled and adjusted by the surgeon.
2. Description of the Prior Art
In the course of such operative procedures as mitral valve surgery or mammary artery surgery, it is necessary to expose the heart. Such exposure has been accomplished by performing either a full or partial sternotomy (cutting an incision through the sternum and retracting the sternum) or by cutting an incision between adjacent ribs. The retraction is accomplished by a thoracic retractor that employs parallel grips that engage the edges of the incision. The grips are mounted perpendicularly to a toothed crossbar. One of the grips is fixed to one end of the crossbar, while the other grip is movably mounted to the crossbar by means of a pinion that engages the teeth of the crossbar. Upon rotating the pinion, the movable grip can be moved away from the fixed grip, thereby retracting the incision so as to expose the heart. Thoracic retractors of the type described are shown in U.S. Re. 34,150, issued Dec. 29, 1992 to A. E. Santilli and D. M. Cosgrove III, and U.S. Pat. No. 6,099,468, issued Aug. 8, 2000 to A. N. Santilli and A. Patel, the disclosures of which are incorporated herein by reference.
After the incision has been retracted, it is necessary to retract portions of the heart in order to expose diseased or defective parts thereof. Such retraction has been accomplished by attaching a cardiovascular retractor to one or both of the grips of the thoracic retractor. The cardiovascular retractor, in preferred form, includes a horizontal rod to which retractor blades having elongate handles are attached by means of universal clamps. The rod is spaced above the grip a considerable distance in order to permit the blades to have access to the heart at a favorable angle. The blades can be moved so as to engage portions of the heart to be retracted. Thereafter, upon pulling the blades and locking them in place by tightening the universal clamps, the heart can be retracted in any manner desired and maintained in that position as long as necessary.
The blades in the described construction can be moved back and forth, up and down, side to side, and they can be pivoted about the longitudinal axis of the handle. Such versatility enables the device to be used for virtually any type of cardiac surgical procedure where retraction is required. Examples of suitable cardiovascular retractors are disclosed in the '150 and the '468 patents.
While the cardiovascular retractors disclosed in the '150 and the '468 patents are effective, it takes a certain amount of effort and skill in order to assemble them properly. After assembly, certain components inadvertently can be moved into undesired positions under the forces that are placed on the retractor during the course of performing a surgical procedure. Moreover, the retractor blades themselves are fixed in shape and therefore are used on a “one size fits all” basis.
There remains a need to improve the manner in which a cardiovascular retractor is attached to a thoracic retractor. Preferably, a cardiovascular retractor could be attached to a thoracic retractor in a very simple procedure that would enable the surgeon to position the components exactly as desired without guesswork or judgment being required. Any such cardiovascular retractor hopefully would have its components retain their initial position under all operative conditions until movement to another position is desired. Moreover, the retractor blades used with the cardiovascular retractor preferably would be adjustable in order to accommodate the anatomy of different patients.